Injectable Platelet Rich Fibrin (i-PRF) for Joint Sounds and Clinical Signs of Disc Displacement by DC/TMD: A Randomized Controlled Trial

Objective: To evaluate the efficacy of injectable platelet-rich fibrin (i-PRF) versus a control solution (lactated Ringer’s) in modulating joint sounds and resolving clinical signs of disc displacement in patients with articular temporomandibular disorder (TMD). Methods: This prospective, randomized, double blind controlled clinical trial enrolled 36 patients with articular TMD. Participants were allocated to two groups: the i-PRF Group (n = 18), which received three monthly intra-articular injections of i-PRF, and the Control Group (n = 18), which received lactated Ringer’s solution. The primary outcome was joint sound intensity measured on a visual analogue scale (VAS). Secondary outcomes were clinical diagnoses of disc displacement with and without reduction (DDWR/DDWoR) based on DC/TMD criteria, evaluated at baseline (T0) and six months post-intervention (T3). Results: The i-PRF group showed a significantly greater reduction in joint sound intensity than the control group (mean reduction: 83.2% vs. 38.7%; p < 0.001). I-PRF also produced a significant resolution of DDWR (66.7% to 16.7%; p = 0.008) and DDWoR (33.3% to 5.6%; p = 0.041). At T3, the proportion of patients with clinical signs of disc displacement was significantly lower in the i-PRF group (p < 0.05 for both DDWR and DDWoR). Conclusion: Intra-articular i-PRF therapy was superior to lactated Ringer’s in reducing joint sounds and resolving clinical signs of disc displacement in patients with articular TMD. I-PRF represents a safe, biologically active intervention for mechanical dysfunction of the temporomandibular joint.